Hodgkin's Survivors/Secondary Breast Cancer

lifelover

Hi everyone,

Is there anyone out there who had Hodgkin's Lymphoma (Disease) many years ago and has had a secondary breast cancer diagnosis?

I had radiation (mantle) 17 years ago for a mass next to my windpipe in my chest.  This week I was diagnosed with breast cancer and am preparing for a double mastectomy and reconstruction.

I would love to connect with other Hodgkin's survivors. 

kle

HI Lifelover,

So sorry to see you are joining this group.  I've found many others on the board, listed under different topics mentioning the Hodgkins.   I  was dagnosed with DCIS ( on one side) 18 years after my Hodgkins in 2008 .  Like you I  had full breast mantle radiation to cure the Hodgkins..   I opted to have a single mastectomy, and have had implant surgery.  

What type of BC were you diagnosed with, and what type of reconstruction are you thinking about?  Our pre-radiated skin does have some drawbacks, but I'm an implant success story.  So I like people to know it can be done.

Hang in there, while this crazy ride begins for you, these boards were a wealth of information for me.   

kle

kerry32

Hi , I'm in that group - diagnosed with Hodgkins 19 years agon and BC 3 years ago.  I opted for bilateral although it was just on one side.  I have not had recontruction yet but am starting to think about it.  I have conversed with KLE through the years so we are a group!  Please post how you are doing and ask any questions.  Best of luck!

katonine

also in this group. Dx'd with Hodgkin's 17 yrs ago, DX'd with BC 2 years ago. i opted for bilateral. had DCIS only on left breast but was told the risk of recurrence was high, between 30 and 50% over next 15 years because i had mantle rads for HL when i was 25 yrs old. did breast recon, with implants. a very difficult experience for me. got implants 3 mos ago and still in a lot of pain. I am told that everyone is different and there is no way to predict whether breast recon will be a succes for women who had mantle rads. I would be very interested in learning what the success rate is of breast recon with implants is on Hogkin's survivors. if you have any questions, feel free to PM me. hope all goes well for you and good luck in making decisions.

lifelover

Great to hear from you all: Kle, Kerry and Katonine!

I had a core biopsy and they only put the needle in twice.  They found cancer cells in the lump (right breast) which is between 1 and 2 centimetres but are unsure what type as of yet.  There is another suspicious lump in my right breast and I also have smaller lumps in my left breast that have not been biopsied. 

My BC recommends bilateral mastectomy with immediate reconstruction because of the likelihood that the lumps are cancerous after past radiation treatment.  Also, they will not radiate the area again.  After doing some research, I agree with this approach and should be having the procedure in the next few weeks (awaiting a date).

I won't know my type, stage and grade until the breast tissue is biopsied.  Oh, I'm also having an auxilliary node dissection, 4 or 5 on each side.

I saw my microsurgeon this week and he won't do a DIEP recon because my stomach just below my belly button was radiated so he has recommended a TUG where they take fat and muscle from the inner thighs.  This is a procedure that they are doing more and more of in Europe as it was pioneered in Austria.  I researched my surgeon and the procedure and I feel that this is the way for me to go.

I think what has surprised me is that they are doing a skin saving mastectomy so are only taking the areola and nipple skin (along with the tissue inside).  I guess with the radiation damage to my breasts I thought they would take all of the tissue.  Ladies, how much tissue did they take from your breast(s)?

I know I can fight this and I've got a very positive attitude, however, I like to be informed.  Oh, and of course, I am a little frightened of the surgery and the waking up just after.

Lindasgirl

Hi Lifelover,

              Although I have been reading this site for many years,I never post. I felt the need to do so on this thread because it hits so close to home.My mom had hodgkins when she was 29(30 years ago) they radiated her chest mantle and cured her of that disease. We never really worried about secondary cancers as a result,as no one ever told her it would be a concern.

             She developed breast cancer 4 years ago and had a mastectomy and chemo. No rads because of the previous treatment for hodgkins. A year after her first mastectomy,she decided to have the remaining breast removed. It contained cancer also,so we were happy she made that choice. 3 years after her breast cancer diagnosis,she was diagnosed with small cell lung cancer. Primary,not mets from breastcancer. Again,she could only do chemo,radiation was not possible..

          The doctors said they believe the breast and lung cancers were a result of the massive amounts of radiation they used"back in the day" for hodgkins. My mom put up a great fight,but we lost her just about 4 months ago. It's so hard,but I'm thankful for all the years I got to have my mom thanks to the treatment that saved her life 30 years ago.

         I am not trying to scare anyone,I just wanted you to be aware that the lungs can also be affected by the radiation for hodgkins and make sure you have the doctors keep an eye on your lungs too.

                                                                       Tammy                                         

lifelover

Hi Tammy and thanks for sharing your story.

I'm so sorry you lost your Mom but I'm so grateful for your advice because it is important for those of us who received radiation (I had 10 weeks of radiation to my chest) to get monitored and the guidelines (NCCN I think it is) for Hodgkins survivors recommend that a yearly chest x-ray be obtained as well as mammography for long-term survivors.  Also, monitoring of the heart is essential as damage can also occur to this area.

My family is more frightened than I am of my diagnosis but I keep reminding them of my cure 17 years ago that allowed me to live a very happy life.

Kim x 

kle

HI Lifelover,

You sound very positive!  Keep up the good attitude, it will be so helpful through this! I also had the skin sparing MX...I was very lucky with the DCIS, no additional chemo needed!  I hope the same for you.

I did not have any lower radiation like you did.   I'm not familiar with the TUG surgery, but it sounds very positive.  

And also to Tammy , sorry for the loss of your mother.  I think we survivors, or at least I did, always had in the back of my mind, that something may pop up in the future..  And I still do follow ups, and will for the rest of my life, thanks for the reminder.

kle

Kadyann

Hi all,

I am also a hodgkins and BC survivor.  Unfortunately I am now dealing with my second bc.  I was treated for hodgkins in 1988 with only radiation and was diagnosed with DCIS w/ micro invasion in 2003.  Had masectomy with LD reconstruction w/ implant.  This past August I felt a rice shaped bump in reconstructed breast and it was bc again.  Not sure if new primary or recurrence because pathology is totally different (first was high grade er/pr- this is low grade er+ her2+) so this time I went the chemo route.  Interestingly enough there was some talk that I possibly could be radiated again but the possible side effects sounded rather nasty and not something that I would probably ever consent to.  I hope that we can keep this thread going because it is so nice to connect with others that have shared a similar experience.

kle

Hi Kadyann,  I'm so sorry to read about your recurrence.  I'd say you've already had your share of this.  Thank goodness you were so aware to catch this new recurrence.....So now that you are done with your treatments, how are you feeling.

That is also interesting you never had the Chemo w/ the Hodgkin's. I was treated with both the chemo and radiation.  And that they offered you radiation now, interesting..no one would support radiation for me if I went w/ a lumpectomy.     

It is nice to be in touch with other Hodgkin patients.

kle

Kadyann

kle,

I am feeling pretty good as i am 9 weeks pfc.  However, emotionally I probably have a ways to go.  I honestly never felt that I would die from the hodgkins or first bc, but now my faith has been shaken.  I was just talking to a friend who is close to her 2 year bc anniversary and said she can't wait for the 5 year mark so she is "cured".  I didn't really have the heart to point out that I was 6 1/2 years out and was still blind sided again.  I can't help but think what have I done that is so wrong/bad that this keeps happening to me??  I hate it but I definitely feel a little resentful.  Guess I am just having a down day.

katonine

Kadyann,

 i just read your post and I just wanted to reach out to you and let you know that you are not alone. i know how you feel,..well, not exactly, but dont ever feel like you did anything to deserve this. i know what u mean, why me? again? i am sorry, you have had a very hard time. i was surprised when i read your post that u found BC after mastectomy? i did not even know that was possible..?... i had BL Mx after DCIS in one breast. so i guess it sounds like we are still supposed to be checking for lumps?

i am new to all this, secondary cancers and yes, i am scared now. i was like you, never thought Hodgkins or BC would kill me but i am having a horrible time with my implants and i feel like i dont even know if i will make it . i just want them out but the Drs wont let me take them out yet cause too early and i am not strong enough yet for another surgery (have had so many in past 2 yrs). i also had a PS who just didn't hear me,...and i am now trying to find a new one .

i am really tired as i write this, and in a lot of pain but i just wanted to tell u that u r not alone, and u didnt do anything to deserve this. for some reason we were picked for this journey of cancers, i really believe there is a reason for all this, and dont worry about having a bad day, i am the same today. can barely type and am so sick of the pain . and you have gone thru it twice now, the BC. you are very strong for even being able to post here. i didnt even have the courage to post on here til a few wks ago. and still can't post too often.

how long ago did u finish chemo? and, what is pfc?

 hope u r feeling better tomorrow. when i am having a bad day i just give in to it. no point trying to fight it. and then the next day is usually better .

Kadyann

Katonine,

 Thanks for reaching out.  Your compassion is very touching. I too feel like there has to be some great meaning behind this journey i just wish that there was an easier way to get there.  Oh well, when I start feeling sorry for myself I just need to sit back and think of the many blessings in my life and all that has gone well.  It is just hard sometimes when I feel like I really do try to take care of myself and I see others that don't and I am the one with cancer.  I finished chemo on 12/28/10.  I had 5 cycles of TCH and will continue herceptin through next October.  I will also be starting tamoxifen soon. pfc is past final chemo.  Take care

lfox

Hello, I am warmly reading these posts. I am a Hodgkin's survivor from 1980, age 23, having had cobalt (no longer used) mantle field RT. I am two weeks post bilat. M with expanders for IDC, node negative. I had a bone scan that showed osteopenia so I am concerned about possible chemo, there is no decision yet. I am so grateful to all your posts and I will continue to lend an ear and support.

dansbetta

Your positive attitude towards breast reconstruction - is prekrastno. From this attitude will depend on your recovery. Good that you have decided on your fabric and not on implontanty. Your breasts will be your! Nipples are often removed along with the tumor, because they represent the glandular tissue and increase the risk of recurrence of the tumor. Reconstruction of the nipple, usually made after breast reconstruction in general is completed. This gives the patient an opportunity to get used to the new breast, and tissues - grow together. During the restoration of the nipple may be slight correction of the shape of the breast. "Prosthesis" nipple - is another option, proposed by surgeons today. It can be both permanent and temporary. Physician to make a copy of your healthy nipple, just pick the color. The nipple is attached to the chest with special glue and glue once a week. Preparing for surgery, such as the introduction of anesthesia and operation for removing the effects of cancer may take about two hours. Once the team of plastic surgeons begin work on the operation goes from one to six hours. The first few days after the operation the most difficult: you may experience discomfort and even pain. But during a stay in hospital for your condition will be monitored closely and if necessary you will be given after surgery obezbolivayuschee.Vskore advise you to move your head and hands, but in no case should not climb out of bed, walk or lift weights. Do not worry: the next day after surgery you are able to sit on a chair beside the bed and the next day most patients are already walking without any pomoschi.Bolshinstvo women returned to a normal lifestyle within six weeks after surgery. But if you strenuously exercise, add to it a few more weeks. After returning home, you may feel pain, do not exclude the appearance of swelling and bruising. The doctor will determine whether you need to apply ointment on the operated area, as well as tell you how to change bandages at home. Be sure to ask about how to bathe and care for the wounds before the leave bolnitsu.Udalenie tumors and breast reconstruction will be left on the body of non-sensitive area. Where you had taken tissue for transplant, instead of pain you may be feeling of tightness or even lack of sensitivity. But over time, most scars will become lighter, and partially returned to the breast sensitivity. 

Apologies for such a long post. I hope this information will help you. I wish you good luck!  

lifelover

Hi lfox,

I'm sorry you are joining this forum but I find some comfort coming here and sharing with others.  I'm happy that you do also.

I had my bilateral mastectomy and immediate reconstruction on the 5th of April.  I'm still waiting for the results of my biopsy from the surgery to know whether I need more lymph nodes removed or chemo.  I had Hodgkins in 1993 and the surgeons now say that my BC is a result of that treatment.  I'm not angry about it though - I believe I lived 17 terrific years since that time due to cancer treatment. 

I also have IDC but with a micropapillary component, making it a bit more aggressive.  Still waiting to be staged, etc. and for pathology on lymph node sampling.

I hope all goes well with your treatment and please update us to your progress.  It is so helpful to hear from other Hodgkins' survivors with BC.

Ishie

I'm one week into recovery from my double mastectomy. Large DCIS tumor in left breast with very small micro-invasion at stage 1 grade 2 er- pr-. I had stage 2 Hodgkins in 1986 when I was 16, treated with both MOPP chemo and cobalt radiation. Nine years ago I had thyroid problems and had 3/4 of that removed, so the radiation just keeps bringing up issues. Right now we are weighing the decision about chemo. Had an echocardiogram today to assess heart condition and that will certainly contribute to our ultimate decision. The 10 year prognosis looks very promising, but then when we look at the relapse statistics, I am more concerned.

Lifelover, I'm with you in that I can't waste energy being angry that 24 years ago the doctors did the best they could and I have been healthy for that long. Right now I just feel like I'm in Vegas and want to do whatever I can to skew the odds in my favor so my now 10 and 7 year olds don't lose their mom before they graduate from high school.

lifelover

Hi Ishie,

My oncologist last week said that Hodgkins Lymphoma survivors who develop breast cancer years later are in a group where statistics are not very accurate and he couldn't quote any reliable statistics to  me.  I, personally, will do whatever I need to do to prevent a recurrence or spread.

I was diagnosed with Invasive Ductal Micropapillary Carcinoma which is a fairly rare and aggressive form of IDC.  It's spread to some lymph nodes and I'll be having FEC-T chemo starting the 9th of May.  One of the problems with the "E" part of the chemo cocktail  in the "FEC" is that it might damage the heart so this is something to consider, certainly with your heart condition history, and also with Hodgkins survivors.  I'll be having a heart scan or test (can't remember what they call it) to ensure I can tolerate it.

Good luck with your decision and I hope you can remain positive and strong.  I had a good cry last week though and it felt good just to let it all out and then I moved on.

Amybrandt

Hi

Your story is almost exact to mine. I had the same mass 19 years ago. The one thing I remember after leaving the hospital back them was the oncologist told me my secondary cancer would be breast cancer. I had my bi-lateral mastectomy last week on May 3rd with reconstruction. Needless to say I am on the mend and looking forward ton each day. My good news was negative lymph nodes and negative BRCA 1/2. I'm so grateful for that with a 3 yr old daughter. Over the past 19 years I really haven't revisited too much information on the studies of HL and BC. I will say that over the past month I know my case has been discussed as part of the local tumor board. Good luck with your surgery. Keep us posted.

Amybrandt

Hi

Your story is almost exact to mine. I had the same mass 19 years ago. The one thing I remember after leaving the hospital back them was the oncologist told me my secondary cancer would be breast cancer. I had my bi-lateral mastectomy last week on May 3rd with reconstruction. Needless to say I am on the mend and looking forward ton each day. My good news was negative lymph nodes and negative BRCA 1/2. I'm so grateful for that with a 3 yr old daughter. Over the past 19 years I really haven't revisited too much information on the studies of HL and BC. I will say that over the past month I know my case has been discussed as part of the local tumor board. Good luck with your surgery. Keep us posted.

lifelover

Thanks Amy.  My surgery went well and my healing is going well except for a continuing infection in my donor site: my thighs.

My chemo starts 23 May (delayed because of infection).  I'm having a PICC line put in my arm because my veins are small and keep collapsing.

I'm getting the results of my bone/CT scans on the 19th and hoping there has been no spread other than my lymph nodes.

I'm still hanging onto a strong and positive attitude

dawn1030

Hello!

I, too, am a 21 year Hodgkins survivor and will be having a double mastectomy/reconstruction next week as I have DCIS. My plastic surgeon has never done surgery on a "radiated chest" as there are so few of us. How did your surgery go??

dawn1030

Hi-

I, too, am a 21 year old Hodgkins survivor who now at age 45 has DCIS. I will be having a double mastectomy this week and reconstruction/expanders. Did you have any delayed healing/infection. How long did it take you to totally heal? I am also having sentinel node biopsies to be on the safe side. Thanks so much for your input! 

lifelover

Sorry that I haven't replied sooner Dawn.  I took a break from this forum after having a rough first week being sick after my first FEC treatment.

My breasts look amazing.  My surgery was the 5th of April.  I've had no infection in my breasts and the scars are barely visable.  I had a skin-sparing mastectomy so they cut around the aerole and took the breast tissue out through that.  They used tissue, muscle and skin from my thighs to create my new "C" cup breasts, aerole and nipples.  It appears that my radiated skin healed beautifully.

I had radiation to my entire upper mantel from my belly up so they could not do a DIEP reconstruction on me.  They would not use radiated skin to reconstruct.  However, they did keep my breast skin as my BC hadn't spread to my skin. 

My TUG reconstruction did leave large scars on my thighs because of infection and seroma problems but hopefully these will calm down or I'll be having more surgery.  I've seen other women's scars 4 months and 1 year post-op and their thighs looked much better than are looking but I think my thigh healing is not complete.

Good luck with your reconstruction Dawn.

Livsmom

I to have had Hodgkins lymphoma in 1982 at the age of 15. In 2001 lobular carcinoma of the left breast with mastectomy no treatment due to all the treatments I had with the HL so here I am again with a right mastectomy for non invasive ductal no further treatments. I am doing implants this time at age 44 I decided to try and see how it goes. So far not to many problems. I am on disability for fibromyalgia and heart and blood pressure issues related to the past treatments but I try and stay positive. It is nice to hear from others that are going throug the same thing. I also have been having basal cell carcinoma skin cancers popping up and a lot of thoracic ( upper back problems) with my discs does anyone else have these problems. And of course anxiety and panic attacks over the past few years have been very hard to deal with.

lifelover

H Livsmom,

I'm so sorry to hear all that you have been going through.  Once diagnosed with cancer, it changes your life.  Yes, in the negative ways of always having to watch your health and the results of that hyper-watchfullness but also in a positive, life affirming way - I now how to get the best out of life that I can and I live each day to the most full I can.

I think the panic attacks (which I've had for a few years) are a result of the worries over health.  I take medication to deal with them now and my health problems are improved.  I have upper back and lower back problems from tension and I used to get sports massage that greatly relieved my problems.  However, as you know, I can't have the massage during treatment so I am tense and in pain with headaches again.  Trying to relax.  As part of treatment here in England at my local hospital we have relaxation classes and complementary therapies (I'm having reflexology) free of charge.  I also listen to relaxation CDs.  It's still hard.

Please feel free to send me a personal message if you want to discuss any of your worries in private.  I know it's very scary and for me, it's difficult to complain to my family about my biggest fears because I know they are thinking them too and it seems easier all around to focus on the positives with them.

katonine

Hi Livsmom,

thanks for posting, sorry you have to join us but at the same time it was nice for me to read your post because I totally relate - I have had panic attacks since Hodgkin's!  I worry, worry, then anxiety turns to panic attack. the breast cancer diagnosis just made that worse. I am trying to deal with them through meditation - I just started a course so I am hoping that will help

Please keep in touch. and I hope there won't be any more cancer scares for you. I think we have paid our dues! 

Livsmom

Thanks katonine and lifelover- I am having a rough time with stomach issues since surgery since the fibro diagnosis the Dr says irritable bowel syndrome made worse by stress. Do any of you suffer with stomach problems. I just wish I could get some energy and the heal faster without eating good it has slowed my progress. I have my first fill on Monday and I'm still very sore on the MX side my other side which had a MX 10 yrs ago is doing well. I am lucky no treatments they wanted me to take tamoxifen but I couldn't tolerate it 10 years ago so I'm hoping for the best. My oncologist told my I'm at a much higher risk for developing other rumors because of the radiation and chemo almost 30 yrs ago but even though it scares me I have to try and be positive. I was told I couldn't have children back then and I went on to have 3 so I feel that my reason for being here is them I also have two grand babies that I adore. But when the fear creeps in I pray and pray and bargain with God to let me see them grow up even though my sons are grown my daughter just turned 6 and I can't bear the thoughts of leaving her. My husband has talked with me numerous times about us deciding who would care for her if we couldnt and I just can't go there. My husband has had some heart problems and we were older when we had her he is 53 no and I am 44. I know many of you probably share in my fears it helps to talk to someone who understands.

cme531

I had Hodgkin's 19 years ago and was told at that time that I was at a greater risk for developing a secondary cancer, most likely breast cancer, 15-20 years later.  I have always kept that information in the back of my mind but never worried about when it might actually happen...  well, it finally has.  I was diagnosed with DCIS about 2 months ago.  The tumor was large and I was given a choice of "attempting" a lumpectomy followed by radiation, or a mastectomy with reconstruction.  I spoke with the plastic surgeon to see what this would entail and ultimately opted for the lumpectomy.  I was thrilled after surgery to find that the margins were clean and that the 3 lymph nodes they removed were negative.  It has been a rough 3 weeks since then, more pain and fatigue than I expected, but still I was very pleased with my decision and so happy all went well.  Last week I saw the oncologist for the first time, and yesterday had my first visit with the radiology oncologist.  I was shocked and sickened to find out from him that I actually cannot receive radiation again and that my only real choice should have been a mastectomy from the beginning.  Excuse me...  the 4th doc I see tells me this 3 1/2 weeks after my lumpectomy??? Now I am saddened, angry and confused...  after reading posts on this forum, I'm afraid reconstruction may not even be an option (they said it would be, but they also said lumpectomy/radiation was an option...  clearly it was not) and now I am wondering if I should/can have bilateral mastectomies with reconstruction.  If that weren't enough, to read about the possibility of lung cancer and radiation induced heart disease from having had Hodgkin's has me feeling anything but positive.  And to think, all of this because I had what the docs referred to as "the best cancer to get" 19 years ago...

lifelover

Hi CME531,

I'm sorry you have been through so much and I understand how you feel.  Even though I am feeling much more positive now since I've had my bilateral mastectomies/reconstruction and am half-way through my chemo I did not always feel positive and it was a huge blow to get a breast cancer diagnosis (even though my Hodgkins doctors said I would have this risk).  My doctors missed my breast cancer the first biopsy 1 1/2 years ago and that made me angry because the lump was directly in front of my Hodgkins lymphoma - they should have given me a further surgical biopsy and they also did not send me an appointment for my next mammo.

I was told that I could not have any further radiation by my breast surgeon at my first consult this past February.  The plan for me was that I could either have lumpectomy or one or both mastectomies with recon.  I chose mastectomies because of the high risk to develop cancer due to the radiation damage 17 years ago.  The chemo was only as a mop-up for any micrometastises in my lymph nodes that were left.

I would have thought that if you decided to, you could now go on to having a mastectomy or mastectomies with recon - are you considering this?  I know it's scary - it was for me but I did not want to risk losing more years with a further breast cancer - I also had a fibroadenoma in my "other" (the non-cancerous) breast.

I remember my doctors saying I had the best cancer you could get back in 1994 but at that time, they did not know that the treatment for Hodgkins would have been so high risk for breast cancer.  Since about 2003, here in the UK it is mandatory to screen all Hodgkins patients using a triple assessment (mammo, ultrasound, biopsy).  I was never contacted about this even though my GP was supposed to have contacted me!!!!  What can I do now?  It's in the past and I cannot undo it.  I intend to fight for my life in the only way I know how to.  My anger is leaving slowly but I now speak up when I think the doctors aren't taking care of me properly.

I'm sorry you are hurting and frustrated and worried.  It's best to get it all out in the open and air your feelings when you need to.  We're here for you and I hope you feel you can use this forum to air your thoughts and share your ideas.

cme531

Lifelover,

   Thank you for responding to my post.  It really does help to have someone who understands. Even though I am sharing my thoughts with my family, I have to warn them not to say something stupid (like "it could be worse") because even though I know that is true, it's not what I want to hear right now.  Unfortunately it is Saturday and I won't be able to make any progress for the next few days.  I have calls in to the plastic surgeon (he was the second doctor I saw when I was still decided whether to have a lumpectomy/radiation vs mastectomy) and the oncologist (third doctor I saw).

 I will definitely have the mastectomy on one side and am wondering if I should just go ahead and have both sides done and am interested in hearing what they have to say now that they are paying attention to all the facts (prior radiation.)  When I saw the plastic surgeon the first time, he was talking about a tissue expander and implant - from what I'm reading that may not be the best choice having already had radiation.  It is very difficult to know who to trust because all along I have gone along with what they recommended and I feel somewhat defeated.  I have also been very strong, mostly for the sake of my children, so that they could see their Mom was a fighter and someone they could be proud of.  Somehow I need to find that fight in me again.

What type of reconstruction did you have done?  I have just begun to read about other options and the latissimus dorsi flap, which seems to me to be what I would need.  Again, I will need to talk to the doctors next week as this is not what was initially recommended.  I did talk to the radiology oncologist again yesterday (so he is the 4th doctor I saw just the day prior who gave me the "news") to see if he would advise bilateral mastectomies and he did not necessarily think so and thinks I should have genetic counseling to assess my risks...  I am almost to the point of let's just get this over with already, take them both.

I really do appreciate your reply and feel better - your posts always seem so positive